Acta obstetricia et gynecologica Scandinavica
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Maternal death, during pregnancy or within 42 and 365 days from the end of pregnancy, was evaluated for a small high-income nation with comprehensive healthcare. ⋯ Maternal mortality in Iceland over a 25-year period up to the end of year 2010 was low, between 5 and 6/100,000 births. A comprehensive national healthcare system with accessible antenatal care in a society with good general living conditions and universal education probably contributed to this.
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Acta Obstet Gynecol Scand · Dec 2015
Comparative StudySurgical methods for tubal pregnancy - effects on ovarian response to controlled stimulation during IVF.
Tubal pregnancy is often treated by surgery: salpingotomy or salpingectomy. Concern has been raised regarding the risk of compromising the vascular and nervous supply to the ovary, following salpingectomy. The aim of this study was to investigate whether the ovarian response to controlled ovarian stimulation for in vitro fertilization (IVF) is reduced after salpingectomy in comparison with salpingotomy, among women undergoing IVF subsequent to surgical treatment of tubal pregnancy. ⋯ Among women undergoing IVF after surgery for tubal pregnancy, the ovarian response was not influenced by the surgical method. Our results do not support the theory that salpingectomy, compared with salpingotomy, impairs ovarian reserve measured as number of oocytes retrieved during subsequent IVF treatment.
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Acta Obstet Gynecol Scand · Dec 2015
Neonatal outcomes after the obstetric near-miss events uterine rupture, abnormally invasive placenta and emergency peripartum hysterectomy - prospective data from the 2009-2011 Finnish NOSS study.
Neonatal outcomes after the maternal obstetric near-miss complications of uterine rupture, abnormally invasive placenta, and emergency peripartum hysterectomy were assessed. ⋯ The prospective data collected from clinicians, combined with the information gathered from national health registers, provided valuable insights into rare maternal near-miss cases. These complications also predisposed stillbirth and neonatal death. In this study, 75% of fetal losses were associated with uterine rupture.
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Acta Obstet Gynecol Scand · Dec 2015
Multicenter Study Observational StudyCan we improve the prediction of pouch of Douglas obliteration in women with suspected endometriosis using ultrasound-based models? A multicenter prospective observational study.
A negative "sliding sign" during transvaginal sonography (TVS) is associated with pouch of Douglas (POD) obliteration at laparoscopy in women with suspected endometriosis. The aim of the current study was to develop and validate mathematical ultrasound models to determine whether a combination of TVS markers could improve the prediction of POD obliteration as compared with the TVS "sliding sign" alone. ⋯ Incorporation of TVS markers such as bowel endometriosis, endometrioma and ovarian fixation into mathematical models does not appear to improve the prediction of POD obliteration as compared with the TVS "sliding sign" alone.
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In the Nordic countries, where there is a real pursuit to keep cesarean section rates at a relatively low level, the efforts to align maternity care to the needs of women reflect a unique approach among high-income countries. Electively performed cesarean section due to fear of childbirth is one example of this increased attention. ⋯ It is very likely, however, that even a fulfilled request for cesarean section is not enough to ensure a positive birth experience. Therefore, a maternal request for cesarean delivery should first be interpreted as a sign of increased maternal vulnerability rather than a need that should be met unconditionally.